Drug interactions
Imatinib + Ketoconazole
Severity: Moderate
Imatinib and Ketoconazole: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketoconazole raises imatinib plasma concentrations, increasing the likelihood of dose-related adverse effects such as fluid retention, nausea, myelosuppression and hepatotoxicity.
What this interaction means in plain words
Imatinib and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Imatinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 metabolism of imatinib and may also inhibit P-glycoprotein efflux.
What to do
Monitor blood counts, liver function and signs of fluid retention, and consider reducing the imatinib dose if toxicity appears. Prefer a weaker CYP3A4 inhibitor if possible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib Major
Frequently asked questions
Can I take Imatinib with Ketoconazole?
MediHelp rates the interaction as moderate. Imatinib and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole raises imatinib plasma concentrations, increasing the likelihood of dose-related adverse effects such as fluid retention, nausea, myelosuppression and hepatotoxicity.
How serious is the interaction between Imatinib and Ketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts, liver function and signs of fluid retention, and consider reducing the imatinib dose if toxicity appears. Prefer a weaker CYP3A4 inhibitor if possible.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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